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ADVANCE Perspective: Physical Therapy & Rehab Medicine

Safe at Work

Published February 4, 2014 11:57 AM by Danielle Bullen

Las Vegas--How can we keep an aging, changing workforce safe and able to work? That was the question posed at this morning's Combined Sections Meeting session "Workforce Trends and Their Impact on PT Practice." Nicole Matoushak, PT, MPT, CEES, CEAS, and Michelle Despres, PT, CEAS II discussed the physiological struggles faced by the aging workforce--in this case, 55 years and older.

 It's no secret the U.S. workforce is getting older. By 2030, it's estimated 19% of the population will be 65 or older. 80% of 50-year-olds plan to work after retirement. So, keeping this population injury-free will be a growing responsibility of physical therapists. Yet it is easier said than done.

The most common injury for an aging workforce is falls. The most common result of those falls are fractures, which take longer to heal with age. There is a slower recovery as people age. For the 55 or greater population, there is an average of 12 lost work days per incident. Compare that to the 25-34-year-olds, where the average lost work time is 6 days. Those injured, aging workers are being treated by PTs for longer than the recommendation duration of care for specific injuries.

Many factors go into this increased falls risk. Strength is 25-30% lower at age 60; flexibility is 18-20% lower at 65. Reaction speed and manual dexterity reduce with age.

Physical therapists might be unaware that common medications prescribed to the elderly population can have unfortunate physiological side effects. Fatigue, weakness, increased muscle mass, increased injuries, and delayed healing time have all been documented

"Sacropenia," from the Greek, meaning "poverty of flesh," refers to loss of muscle size and strength," and it is a major contributor to age-related injuries. By the time someone is 80, they've lost 1/2 their muscle mass.

Fortunately, that loss can be minimized through strength training programs. Physical therapists need to look beyond the current injury they are treating and examine the patient's total health. "We have great opportunity as PT professionals to work on the wellness aspect," said Matoushak."



Keeping up with our patients of older age is extremely important. On a current clinical, I am treating a lady in her late 70s who works as a cashier at a grocery store. She has been having increased back pain and difficulty climbing stairs. She also has fairly severe scoliosis. By strengthening the patient in the pool and transitioning to land based therapy, she has made incredible progress and is now able to work an 8 hour shift with no pain when prior to therapy she could not finish a 4 hour shift. Education is something that comes naturally to therapists and through body mechanic evaluation and education, this patient has also reduced her risk for further injury. When working with older patients, we must consider "the norm" for their generation during their younger years. Gyms and fitness were not as "popular" or as well advertised as they are today. In treating patients, we must continue to take the time to get to know them and build a trusting relationship so they realize what we tell them is not a generic script but truth and keeping their best interests at the forefront.

Noelle, DPT - Student March 9, 2014 10:59 AM

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